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Does total orthotopic heart transplantation offer improved hemodynamics during cellular rejection events?

April 26, 2017cellular events heart hemodynamics Offer orthotopic rejection total transplantation

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Does total orthotopic heart transplantation offer improved hemodynamics during cellular rejection events?

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Aleksic I; Freimark D; Blanche C; Czer LS; Trento A Department of Thoracic and Cardiovascular Surgery, University Essen, Essen, Germany. ivan.aleksic@uni-essen.de BACKGROUND: We hypothesized that total orthotopic heart transplantation (TOHT) improves hemodynamics during cellular rejection compared with biatrial transplantation (SOHT). METHODS: We reviewed 1942 biopsies from 134 patients (pts) and right heart catheterization data obtained at endomyocardial biopsy. Biopsies that displayed cellular rejection grade 1B as classified according to International Society for Heart and Lung Transplantation (ISHLT) criteria were analyzed. Pts with pacemakers, atrial fibrillation, or beta-blocker therapy at the time of biopsy were excluded. Twenty-three pts after TOHT and 38 after SOHT were identified to match these criteria. RESULTS: Demographic data and pretransplant hemodynamics were similar. TOHT pts had a higher mean cardiac index than SOHT recipients (3.3 +/- 0.8 vs 2.7 +/- 0.5 L/min/m(2); P